HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
' - -_- - - FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
NOV 05 2018
PERMIT RENEWAL REQUEST
ST. Lucie County, F'Prmitting
PERMIT NUMBER: y Jcb ADDRESS: ]95' k1 I`d LN
I, �enniS Zai'e K —, am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
OWNER/BLMY OR CONTRACTOR SIGNATURE AT
finis ZaceK
Print Name
STATE OF FLORID
COUNTY OF 5-. �,�� �d
ACKNOWLEDGED BEFORE ME THIS_(InAY OF 20—&
BY ,I �� �,� �WHO IS PERSONALLY KNOWN TOME 1-" OR
HAS PROVIDED AS IDENTIFICATION.
%GNATURE
FLORID o f . U� d►a°!�s'. COLEEN SULUVAM
ig A
Eff" h MY COMMISSION#GG071535
OF ARY SE EXPIRES February 09,2021
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x .65=$113.75(renewal fee)
Revised 7/21/2014
5`1W 3